Free access to the on-line Palliative Care Formulary renewed for NHS Scotland

26th March 2015

We are delighted to report that NHS Education for Scotland has subscribed to the on-line Palliative Care Formulary (PCF) for a third year. The on-line PCF is hosted on the Palliative Care portal of the NHS Scotland Knowledge Network website and is available free of charge to those with an NHS Education Scotland ATHENS user name and password. The content is continually updated and represents the most current PCF version.

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Court ruling requires NHS England to issue guidance for the prescribing and dispensing of pregabalin for neuropathic pain

10th March 2015

Generic pregabalin capsules are now available in all usual strengths (25mg, 50mg, 75mg, 100mg, 150mg, 225mg, 300mg and 600mg) authorized for epilepsy or generalised anxiety disorder only. 

The patent for the use of pregabalin in central and peripheral neuropathic pain resides with the Lyrica brand of pregabalin capsules (Pfizer) and does not expire until 2017, making Lyrica the only product authorized for such use. 

Following a legal dispute, a court ruling has required NHS England to issue guidance for the prescribing and dispensing of pregabalin which states that when used for neuropathic pain, the brand name Lyrica should be written on the prescription (NHS England prescribing guidance). 

Note: gabapentin is an alternative first-line option for neuropathic pain (see our Gabapentin and pregabalin monograph). Generic gabapentin capsules, authorized for peripheral neuropathic pain, are as effective as, and significantly cheaper than, the Lyrica brand of pregabalin.

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New vision for co-ordinated end of life care published

5th March 2015

National Voices in collaboration with the National Council for Palliative Care, and NHS England have published a new vision for co-ordinated care for people near the end of life ‘Every Moment Counts’.

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New drug driving legislation now in force

2nd March 2015

The new offence of driving or attempting to drive with certain controlled drugs above specified limits in the blood came into force today, in England and Wales. The legislation covers eight illegal drugs and eight prescription drugs, including:

• benzodiazepines; clonazepam, diazepam, lorazepam, oxazepam, temazepam
• opioids; diamorphine, methadone, morphine
• psychostimulants; amphetamine
• others; cannabis-based medicines (e.g. Δ⁹-tetrahydrocannabinol), ketamine.

The main focus of the new law is the illicit use of these drugs. Accordingly, provided driving is not impaired and the drugs are being taken as directed either by a health professional or the Patient Information leaflet (PIL), drivers lawfully using these drugs are exempt from prosecution (the ‘medical defence’). Thus, it is important to inform patients of this if prescribed these drugs and they intend to drive. The MHRA and Department for Transport have produced information for patients (see below). PCF Chapter 19 on drugs and fitness to drive will be updated shortly.

MHRA: Information for patients

Department for Transport: Guidance for health professionals

Department for Transport: Information for patients

Department for Transport: Drugs and driving 

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Save 33%: Strong opioids and the relief of cancer pain booklet

2nd March 2015

The booklet Strong opioids and the relief of cancer pain; Information for patients, families and friends (produced by the editorial team of the Palliative Care Formulary) has been reduced to £3.99 (from £5.99) while stocks last. The question and answer style booklet, which carries the prestigious Crystal Mark for clarity, was published in December 2013 (see our news item 17th December 2013).

Some example questions answered include:

• Will I become addicted?
• How soon will I become pain-free?
• What should I do if I forget to take a dose?
• What can I do if the pain comes back between regular doses?
• What about unwanted effects with skin patches?
• Do strong opioids have many unwanted effects?
• What is 'spinal' morphine?

It is available via our store now priced £3.99, (discounts available for purchases of 10 or more) or from amazon.

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NICE Guidelines on bladder cancer

1st March 2015

The NICE Guidelines on the diagnosis and management of bladder cancer (NG2) have now been published.

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